Baseball is America’s pastime and one of the most popular sports played by our youth; an estimated 4.8 million children 5 to 14 years of age participate annually in organized and recreational baseball and softball. Although rare, catastrophic impact injuries from contact with a ball or a bat have raised safety concerns over the years. These injuries, along with more common shoulder, elbow, and eye injuries are the subject of this study. Generally, however, baseball and softball are considered relatively safe sports with catastrophic and chronically disabling injuries being very rare.

Baseball Injury Statistics

  • Between two and 8 percent of baseball players are injured while playing the sport each year.
  • 162,000 baseball, softball and tee-ball injuries among children between the ages of 5 and 14 years were treated in emergency departments in 1995.
  • Peaking at age 12, the number of injuries experienced by each child generally increases with age.
  • Of the injuries, 26% were fractures, and 37% were contusions and abrasions. The remaining injuries were strains, sprains, concussions, internal injuries, and dental injuries.

The potential for catastrophic injury resulting from direct contact with a bat, baseball, or softball exists. Deaths have occurred among baseball players from impact to the head with a bat or baseball. The result can be intracranial bleeding or blunt chest impact, probably causing ventricular fibrillation or asystole (commotio cordis).

Little League Elbow

The term “Little League elbow” refers to medial elbow pain attributable to throwing by skeletally immature athletes. Pitchers are most likely to be affected by this condition, but it can occur in other positions associated with frequent and forceful throwing. The throwing motion creates traction forces on the medial portion of the elbow and compression forces on the lateral portion of the elbow. Early recognition of the symptoms is important to avoid chronic elbow pain, instability, and arthritis.

Baseball Safety Recommendations

The American Academy of Pediatrics recommends the following safety guides:

  1. Preventive measures should be used to protect young baseball pitchers from throwing injuries. Preventive measures include restricting the number of pitches thrown during games and practices and instruction in proper training, conditioning, and throwing mechanics. Parents, coaches, and players should be educated about the early warning signs of an overuse injury and encouraged to seek swift and appropriate treatment if evidence of an injury develops.
  2. If safety equipment is used effectively during games and practices, most serious and potentially catastrophic baseball injuries can be avoided. Safety equipment includes the use of approved rubber spikes, batting helmets, masks, and chest and neck protectors for all catchers. Protective fencing of dugouts and benches, the use of break-away bases, and the elimination of the on-deck circle are also recommended. Protective equipment should always be properly fitted and well maintained.
  3. With baseball being the leading cause of sports-related eye injuries in children, players should be encouraged to wear polycarbonate eye protectors on their batting helmets to reduce the risk of eye injury. These eye protectors should be required for functionally one-eyed athletes (best corrected vision in the worst eye of less than 20/50) and for athletes who have experienced a serious eye injury.
  4. Low-impact NOCSAE-approved baseballs and softballs have shown to cause less damage on impact when used among children 5 to 14 years of age.
  5. Developmentally appropriate rule modifications, such as the avoidance of head-first sliding, which can cause serious head injuries should be imposed on children younger than 10 years.
  6. Note: There is not sufficient data to support the use of chest protectors on all players, besides catchers.

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